Dream on

After bone cancer sidelines his football ambitions, a determined athlete beats the odds and returns to the field—as a Gopher walk-on

Athletic and energetic sixth-grader, Casey O’Brien was in his element as a ball boy for the University of Minnesota Golden Gopher football team. “I never really thought I would have the chance to play at that level, but I had it in the back of my mind,” he says. “That was my dream.”

And he worked hard to make his dream a reality. But while he was quarterbacking his freshman squad at Cretin-Derham Hall in St. Paul, O’Brien’s left knee started getting sore. The pain got bad enough that he couldn’t run.

“They never doubted anything, never doubted me ... I’m just thankful for everybody on the [medical] team.”

— Casey O’Brien

After a couple of misdiagnoses, the O’Brien family got the devastating news: Casey’s knee pain was caused by osteosarcoma, a rare type of cancer that occurs in bones. O’Brien quickly went from leading his team to possibly being sidelined forever.

The O’Briens traveled around the country looking for the best care for Casey. Each hospital pointed them back to their own backyard, University of Minnesota Masonic Children’s Hospital—whose cancer specialists are part of one of the country’s preeminent osteosarcoma research programs through the Masonic Cancer Center, University of Minnesota.

“We can go to our colleagues in the lab and say, ‘These are the observations we’re making in the clinic. How can we make those therapies better? How can we make the outcomes for these patients better?’” says Weigel, who holds the Lehman Family/Children’s Cancer Research Fund Endowed Chair in Pediatric Cancer and directs the U of M Medical School Department of Pediatrics’ Division of Pediatric Hematology/Oncology.

“The really important thing is the philosophy in an academic institution that there is always the quest for new knowledge. We know what the latest treatments are, and we are striving to improve outcomes by integrating new knowledge. So that plays a role in how we approach a situation like Casey’s.”

O’Brien’s treatment involved chemotherapy, surgery, a
knee muscle transfer, and a knee replacement. “He’s had
the best possible outcome that anyone could imagine,”
says his orthopaedic surgeon, Denis Clohisy, M.D.

COURTESY OF DENIS CLOHISY, M.D.

Grinding through

The medical team decided on a plan that included 24 rounds of chemotherapy to shrink the tumor, surgery to remove it and replace it with 5 inches of cadaver bone, a knee muscle transfer, and a knee replacement.

O’Brien, a multisport athlete diagnosed at the start of hockey season, wanted to know when he’d be back on the ice.

“They said, ‘You’re done playing physical contact sports. We’re just trying to save your leg right now,’” he recalls. “That was pretty tough to take at the time because that was the only thing I knew—playing sports.”

The magnitude of his situation sank in.

“The primary concern is that treatment will fail and the child will die,” says Clohisy, head of the Medical School’s Department of Orthopaedic Surgery and holder of the Roby Thompson Chair in Musculoskeletal Oncology. “The secondary goal is to preserve the most function possible in the knee.”

Still, O’Brien never let go of the prospect of returning to the sports he loved. And he did get to return to his high school football team—not as the quarterback but as the holder, a low-contact position.

“When I was in the locker room, I was just another kid,” he says. “I wasn’t any different from anybody else. I got coached the same way as everybody else, had to put in the same amount of time as everybody else, and there was nothing different from me to the next guy. That was one of the reasons that football was so important to me—it made me feel like I was just a normal kid.”

And he lived like a normal kid again—for about a year. Then his cancer returned, this time in his lungs. It meant more chemotherapy and more surgery.

O’Brien faced it head on. The first time he went through treatment, he says, he was scared and in shock. The second time, he was mad.

“I thought, ‘There’s no way I’m not going to beat it this time again.’ So that’s kind of how I went about it. I just grinded out the weeks and ended up battling through it.”

Coming home after his first round of treatment, O’Brien found that his friends had put up a collection of signs in his yard with words of encouragement. “This was one of them. I just picked it out and was like, ‘This one’s awesome. We gotta keep this one.’ And so my mom would bring it every time I’d go to the hospital for treatments.” It still hangs on the wall of his bedroom at home.

Ann Meyer

Back in action

That football mentality—plus the many hours he’s put into rehabilitating his knee—has served him well. Gopher football coaches had heard O’Brien’s story and offered him a chance to walk on to the team.

“The Gophers are incredibly important to Casey, and he is everything that our culture is about,” says head coach P.J. Fleck. “He deserves to be able to live his dream, and we wanted to make sure that he can. Casey is going to be a holder for us, and I know he is going to work hard to be an elite football player and man.”

O’Brien is also pursuing a finance degree from the U’s Carlson School of Management.

“He was always working toward the future—always working on schoolwork, always working to stay physically active,” Weigel recalls. “Even when a short walk around the hospital was all that he could manage, he got up and did it. ... I can’t tell you how impressed I am by Casey. He’s got an amazing heart.”

And O’Brien? He’s happy to be back in action and grateful for the doctors and nurses who helped him get there.

“They never doubted anything, never doubted me,” he says. “I’m just thankful for everybody on the team ... because I probably wouldn’t be here without them.”

When research informs care, and vice versa

Could the next big advance in treating osteosarcoma come from the University of Minnesota? That’s what a national Phase I-II clinical study projected to open later this fall through the Children’s Oncology Group aims to find out.

The study will determine the optimal and safe dose of a new medication in children with recurrent osteosarcoma and other cancers. Developed in partnership with a company called Vaccinex, the medication is designed to inhibit the gene SEMA4D, which was found in a U of M lab to be associated with the bone cancer’s growth.

This effort got a big boost from the Zach Sobiech Osteosarcoma Fund of Children’s Cancer Research Fund, Karen Wyckoff Rein in Sarcoma Foundation, Randy Shaver Cancer Research and Community Fund, and other benefactors, as well as the National Cancer Institute and American Cancer Society.

“The reason that the University of Minnesota has become successful in the research around osteosarcoma has really been driven by focused philanthropy,” says University of Minnesota Masonic Children’s Hospital physician-scientist Brenda Weigel, M.D., M.Sc. “I honestly do not think we would be where we are if it hadn’t been for the philanthropic investment.”

To learn how you can support this research, contact Jen Foss at 612-626-5276 or foss@umn.edu.